Obstetrics and Gynecology - A. M. Gromova 2000

Breech presentation. Course of pregnancy and labor
Clinical features and management of labor in breech presentations
Management of labor in frank breech presentation using Tsovyanov's method

The purpose of this method is to maintain the normal flexion of the fetus throughout the Second Stage of labor, which prepares the birth canal for the passage of the fetal HEAD and prevents the arms from nuchal displacement.

When delivering assistance using the Tsovyanov maneuver, it is necessary to grasp the crowning breech with both hands, placing the thumbs on the fetal thighs and the remaining fingers along the sacrum. This hand placement prevents sagging of the breech and premature prolapse of the legs. By pressing the fetal thighs against the abdomen, the physician directs the torso upward and gradually moves their hands toward the vulvar cleft to prevent the arms from being thrown back over the head. After the fetus is born up to the angles of the scapulae, it is directed first toward the attendant and toward the corresponding maternal thigh (to the left thigh in the first position) to facilitate the delivery of the anterior arm, and then slightly upward to release the posterior arm. Simultaneously with the birth of the posterior arm, the fetal legs usually drop out. As a rule, this is sufficient to assist in delivery. The head is born spontaneously or with the aid of the Mauriceau-Smellie-Veit maneuver.